Jurgen Wasem is one of Germany’s best-known health economists. In his opinion, the large capacity of ventilation beds in Germany is also related to financial incentives. Hospitals could make a lot of money with artificial respiration.
The fact that the mortality rate for corona infected patients in Germany is lower than in many other countries is mainly due to the larger capacity for intensive care and ventilation beds. German hospitals currently treat even about 200 seriously ill corona patients from other countries. "This is our understanding of European solidarity.", explained health minister Jens Spahn before the meeting of the so-called Corona cabinet.
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According to health economist Jurgen Wasem, these large reserve capacities are also due to a misaligned incentive in the health care system. "With artificial respiration really much money is made. This is a misguided incentive of the per-case flat rate system. Many clinics are exhausting ventilation options", explains the head of the chair for medicine management of the University of Duisburgssen in the interview with the "world"-Newspaper.
Ventilation beds are highly remunerated
Ventilation beds are very highly remunerated to hospitals. That’s why hospitals would often keep patients on ventilator for as long as possible – even if the medical benefits are controversial. "Compensation increases significantly if ventilation is at least 95 hours. You will therefore find few patients who are ventilated for 94 hours", says Wasem.
The pressure of the administration on the hospitals was enormous. Therefore, they would often think economically. Wasem calls it "perverse. However, without this misguided incentive, Germany would not have this high capacity of intensive care beds, the health expert believes.
Wasem wants to retain financial incentives in the healthcare system
To ensure patients are ventilated only as long as medically necessary, the financial incentive must be weakened, he said. However, there was also a danger that the effect could be reversed. "It must never be economically harmful for a hospital to ventilate patients. Otherwise this could cost lives", said Wasem.
According to Wasem, it is therefore not a good idea to completely abolish financial incentives. It would be better to create several different financial elements. Flat rates per case are to be only one element of financing, but not the only one.